Supporting Them

I’m concerned about someone

At some point in life, everyone has someone they become worried about. Whether it’s because of a life event that has been traumatic or just because you’ve noticed changes in their behaviour. Sometimes it is difficult knowing what to do to support someone else, especially if you think they might be considering suicide.

Whilst a lot of what can be done is the same as if it was yourself, the hardest part can be starting the conversation with someone.

Talking about suicide

Talking about suicide is not something any of us expect to do and it can feel scary. If you are concerned about someone, either because of their behaviour, actions or words, or perhaps your gut instinct tells you something is wrong, it’s always best to state your concerns and ask them directly –

I’ve noticed [how hopeless you say it all is (for example)] and I am concerned you may be thinking of hurting yourself and so I need to ask, are you thinking of taking your life?

By saying what you have noticed, it makes it harder for them to deny something is off. Asking the direct question about suicide means they are likely to give a ‘yes’ or ‘no’ answer which ensures there is no confusion and they will understand you are asking them about suicide and nothing else. Often, just feeling able to share their feelings about suicide can bring someone great relief.

For years people have believed that asking someone about suicide will ‘put the idea in their head’. This is a common misconception. If someone is not thinking about suicide, you suggesting that you are worried they might be, WILL NOT plant a seed. However, if they are suicidal and you don’t ask, you may be confirming their belief that nobody sees them and nobody cares. If you ask the question and they are not, all you have done is demonstrate that you are someone they can come and talk to about suicide if they ever find themselves experiencing suicidal thoughts or feelings. You can learn more about asking the direct question on safeTALK training.

How will I know if they are thinking about suicide?

It’s possible you won’t! Some people who are suicidal will work hard to ensure nobody knows. However, we believe there are ‘signs’ more times than not - it’s just they may not be shown to you.

In safeTALK these ‘signs’ are referred to as an ‘invitation’. Some invitations may be obvious and others more subtle. Whilst some people may find it easy or be comfortable with expressing thoughts of suicide directly, many will find it difficult to express how they are feeling and the signs or invitations they send out are not verbal.

There is no complete or fully comprehensive list of ‘invitations’ as everyone is individual and unique but changes in their language or words such as “I can’t do this anymore”, “the world doesn’t need me”, “I’m replaceable”, “no one would miss me if I wasn’t here” or “my friends/family would be better off without me” could all be indicators that someone is thinking about suicide. There may be behavioural changes such as losing interest in things that would normally be engaging, withdrawing, giving away or destroying possessions, or physical changes like weight loss or gain, poor hygiene or not caring about their appearance. They might express feelings such as hopelessness, guilt, shame or worthlessness. All these are invitations for someone to notice that things are not right and to ask them directly about suicide.

This is of course, not as easy as we would like, not least because children and young adults may display many of these changes due to hormonal changes and the typical issues around transitioning from childhood to adulthood. There is no magic formula or algorithm that enables us to know exactly what creates suicidal thinking in the people we care about. If you have any concerns or worries, best practice is clear, always ask if they are considering suicide. Research shows that this can actually reduce the risk of a young person ending their life. If you are mistaken, the worst that will happen is an awkward conversation, but at least that person will now know you are someone they can come and talk to about suicide should they ever need to.

What if they say yes?

Stay calm and listen to that person. It takes a lot of courage to open up about feeling suicidal and when someone expresses suicidal thoughts they should always be taken seriously. This conversation needs to focus on helping the person stay safe. Your personal views of suicide are not relevant so please put those to one side.

Avoid phrases that belittle or undermine how they are feeling such as “you shouldn’t care about that” or “you’ll get over it”. Keep the focus on them and try to be empathetic. Try to imagine what it is like for them and focus on their thoughts and feelings instead of your own. Don’t rush to fill silent pauses, instead, give them the chance to expand on what they are saying. If you do reach a point where they have nothing else to say, it is time to consider what needs to happen next.

This will very much be determined by your relationship to them, the time of day or night and whether they are sharing that they are feeling like they can’t go on, or if they have a plan and the means to kill themselves

If you believe this is an emergency and they are likely to try and kill themselves in the immediate future then you need to call the police or take them to their GP or A&E. People often worry that this is a waste of NHS time and resources but taking them yourself, or calling an ambulance to take them to the nearest A&E is the correct thing to do.

You can also call the police on 999. The police attend calls like this every day and have the resources to find vulnerable people whilst working alongside other emergency services to provide the help they need. Even if you have very little information about someone, with a name and a mobile number the police stand a good chance of being able to locate that person.

If it’s not a clear emergency and you are a friend, acquaintance, or perhaps a passer-by, you may need to consider helping them identify someone else they trust who you can contact, this person may already be supporting them - a friend, relative or health professional. You can support them to call or make the call for them.

Non-judgemental listening can be invaluable. Whilst positive thinking has a role to play in wellbeing and happiness, offering positive quotes, platitudes or ‘pick me up’ sayings is a lot less helpful than you might think at this point. Instead, repeat phrases they use to reflect on and clarify what they mean, giving them the time they need to say everything they want to. Allow them to fully describe and explain everything that has happened and how they are feeling. Things that may seem really small to you may be having a big impact on them so be patient and understanding.

Be honest. If you’re terrified and you have no idea what to say, that’s absolutely okay! This isn’t just scary for them, it’s scary for you too and you can tell them that. You’ll need to acknowledge the importance of what they’ve said and be positive that they’ve chosen to talk to you about how they’re feeling. Being honest about the fact that you don’t know what do say or do, but by reassuring them that you are glad they were honest with you, means you will continue to build trust. With that trust, together you can start looking at what you do next.

By attending our ASIST training, you will learn the skills and process to create a “safeplan” with someone experiencing suicidal thoughts. A safeplan isn't a plan for how someone rids themselves of thoughts of suicide, it looks at staying safe right now so that they still have the chance to fight another day and access support for whatever is impacting on those thoughts overall. Find out more about ASIST training.

Where do we get help?

There are lots of different places you can get help and support from. There are helplines, professional support, medications, peer support and self-help. Check out our What help is out there? section to read more about all the different types of help or have a look at our services and information directorysection. Different people will feel comfortable with different types of help so what’s important is that you find something that they will engage with. Rethink have created over 100 factsheets covering topics ranging from benefits support to specific mental illness such as Borderline Personality Disorder.

What about me?

Supporting someone who feels suicidal is emotionally and mentally draining. You may feel angry at that person and have lots of questions that can’t be answered, as well as having many other emotions running high. To be able to look after someone else, you must be sure to look after yourself too.

How you look after yourself will be personal to you. Everyone is different and what helps one person may not help another. The most important thing is that you take some time out for yourself to practise self-care. Check out our Looking after you and self-caresection for more advice on how you might do this and please note that you may need to talk to a professional to debrief - if that’s useful then make sure you give yourself that time.